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Although most falls do not cause injury, the results of a fall can be serious. If you break a bone this can lead to long-term disability. Broken bones do not always heal completely as you get older and a serious injury could mean that you would no longer be able to live without support. This is why, if you are aged 65 or older and have had a fall, it is important to see your doctor to find out if anything needs to be done to prevent you from falling again.

What causes falls in older people?

People of all ages have falls. In many cases they are caused by a minor accident and the person comes to no harm. Older people who have falls, however, are likely to have more serious injuries and to fall over again.

There are many reasons why falls happen in older people, such as:

Hazards in the home.

Ill-fitting footwear.

Muscle weakness: this can be due to lack of exercise, a stroke or glandular problems (for example, thyroid or adrenal disorders, steroid medicines).

Problems with walking and/or balance.

Arthritis: painful joints can make you less nimble and want to move around less. Lack of exercise can lead to muscle wasting and weakness.

Dizzy spells: this can be light-headedness, a feeling that the ground is moving or a feeling that you or the surroundings are spinning.

Confusion: this can be due to medicines, brain problems such as dementia (see below) or general illnesses such as infections.

Postural hypotension: this means a sudden drop in blood pressure when you stand up. It usually happens within the first few weeks of starting blood pressure tablets. Occasionally it can be due to a lack of fluid in the body (dehydration) or to a condition affecting the nerve supply to blood vessels (autonomic neuropathy).

Fainting: this means a loss of consciousness which comes on suddenly and lasts for a short time. It can happen for many reasons. Postural hypotension and heart problems are common causes. It can also be caused by fits as a result of epilepsy or alcohol withdrawal.

Alcohol: apart from the fact that alcohol can make you drowsy and clumsy, it can also cause long-term medical problems that make falls more likely. These include peripheral neuropathy. This is a condition of the nerves that can cause numbness and pins and needles of the feet or problems with balance sensation. A disorder of the brain (Wernicke-Korsakoff syndrome) can also cause falls.

Problems with vision: for example, clouding of the lens of the eye (cataract) and visual field defects, where part of the field of vision appears to be missing. Breakdown of the cells lining the back of the eye is known as age-related macular degeneration. It is a common cause of poor vision in older people. Sometimes an outdated prescription for glasses or bifocal lenses may increase fall risk. Older people at risk of falling may be better with two different pairs of glasses.

Problems with the brain and nervous system: this includes strokes, Parkinson's disease, peripheral neuropathy (commonly due to diabetes), and dementia - a condition involving loss of thinking ability due to Alzheimer's disease and several other causes.

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See your doctor

If you have had a fall or feel you are at risk of having falls, you should ask your GP to do a falls risk assessment. This involves a general check-up (for example, blood pressure, weight, and examination of your circulation and lungs). This is carried out to make sure you do not have any conditions likely to increase your risk of falls.

If you do have a long-term condition such as diabetes, the doctor will check that this is not causing complications likely to lead to falls. You may need tests to check whether you have any conditions which make it more likely that you will break a bone if you do fall (for example, osteoporosis). The doctor will also check your medication to make sure you are not on any medicines likely to cause problems.

Your GP will be able to give you contact details of any other support that is necessary, such as the council or social services. If the doctor finds that your risk of falling is high (for example, if you are an older person who has already had a fall), you may be offered help from a hospital-based falls clinic or local falls prevention service.

Take lots of exercise

Keep active and exercise as much as you can. This strengthens muscles, keeps joints supple and works the systems in your body which control balance and movement. A physiotherapist may be able to suggest an activity programme but you should take the lead in deciding what sort of exercise you are most comfortable with. For example, some people enjoy attending an exercise class whilst others prefer to take up activities such as dancing, swimming or t'ai chi. Activities which develop muscle strength and balance are particularly helpful.

Eat healthily

Healthy eating is important to stop you becoming deficient in vitamins (especially vitamin D), iron, starchy foods and proteins. Keep up your fluid intake to stop you becoming low in body fluid (dehydrated).

Be sensible about alcohol

You should drink alcohol sensibly. Advice can be found in the separate leaflet called Alcohol and Sensible Drinking. If you are already at increased risk of falling (for example, if you are an older person who has already had a fall), even moderate drinking can increase your risk of having a fall.

Have your eyes tested regularly

Have your eyes checked every two years, or as often as your optician advises. If you are already having problems with your eyes, get them checked now. People aged 60 or over can have a free eye test.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.